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Difference between revisions of "Liver pathology"
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=Biopsy= | =Biopsy= | ||
== | ==Stains== | ||
*The stains orders (initially) are dependent on the clinical history. | |||
*#Anything with "tumour", "mass", or "query metastasis": 3 H&E stains. | |||
*The | *#Everything else is assumed to be "medical". | ||
Medical liver biopsy stains: | |||
*[[PAS]]. | *[[PAS]]. | ||
**Useful for microvesicular steatosis. | **Useful for microvesicular steatosis. | ||
| Line 196: | Line 180: | ||
*Reticulin - demonstrates architecture. | *Reticulin - demonstrates architecture. | ||
Additional stains:<ref name=ap27may09/> | ===Additional stains/IHC=== | ||
Non-standard stains: | |||
*[[Oil red O]]. | |||
**Useful for steatosis, not commonly done. | |||
Common IHC:<ref name=ap27may09/> | |||
*CK7 - bile ducts, and bile ductules +ve. | *CK7 - bile ducts, and bile ductules +ve. | ||
*CD34 - should be -ve in normal liver. | *CD34 - should be -ve in normal liver. | ||
**CD34 marks endothelial cells - these are not present in a healthy liver lobule. | **CD34 marks endothelial cells - these are not present in a healthy liver lobule. | ||
===Medical liver adequacy=== | |||
Liver biopsy specimens should be:<ref>{{Ref MacSween|418}}</ref> | |||
*2.0 cm in length and contain 11-15 portal tracts, | |||
*The core should be deeper than 1.0 cm from the liver capsule; specimens close to the capsule may lead to over grading of fibrosis. | |||
===Components=== | |||
Specimen, procedure:<br> | |||
Diagnosis. | |||
<br> | |||
The diagnosis usually contains grading and staging information, e.g. ''activity 2 /4, Laennec fibrosis stage 1 /4''. | |||
In the context of medical liver disease: | |||
*Grade = inflammation/activity. | |||
*Stage = severity of fibrosis/architectural changes. | |||
Notes: | |||
*The term "acute" is infrequently used in liver pathology. | |||
*In the liver: neutrophils ''is not'' acute -- unlike most elsewhere in the body.<ref>OA. September 2009.</ref> | |||
=Liver injury terms/histologic findings= | =Liver injury terms/histologic findings= | ||